Is this a kickback scheme?

[anonymous]

I worked for CSO, contract sales organization. About 400 representatives were contracted to a major pharmaceutical company. A second CSO of about 400 representatives were similarly employed by the same pharmaceutical company to promote the same products. The parent major pharmaceutical company also directly employed a sales force.
The CSO representatives were required to conduct web based speaker programs. The speaker was generally in their own office and.The programs were generally conducted in a practioner's office. Lunch provided by the CSO representatives. An I Pad with web access and a cell phone were used to provide access to slides and.to ask questions of the speaker. Each program was.managed by a third party vendor. Practioners were nominated by the parent company representatives and trained by the parent company. Practitioners could be from all types of health care provider.
In late 2016 were required to conduct 9 such programs annually. This is up from three/year. Could this be considered a kickback scheme?

 

[Constantine Cannon]

The Anti-Kickback Statute, 42 U.S.C. § 1320a-7b(b), extends to all medical providers in a position to arrange or recommend medical services. “Referrals” under the Anti-Kickback Statute include “any item or service for which payment may be made in whole or in part under a Federal health care program.” While the Anti-Kickback Statute covers a broad range of activity, it also requires a showing of an “intent to induce referrals.” Claims for payment submitted to Medicare or Medicaid that include items or services resulting from a violation of the Anti-Kickback Statute are deemed to be false claims under the False Claims Act, even if the defendant did not have the specific intent to commit a violation of the Anti-Kickback Statute.

Therefore, providers may not argue that they did not know they were violating the FCA because they were not aware the Anti-Kickback Statute existed. Our law firm has compiled a list of informational resources relating to the Anti-Kickback Statute that may be of interest to you: https://constantinecannon.com/practice/whistleblower/whistleblower-types/healthcare-fraud/anti-kickback-stark/.

The information contained herein is for informational purposes only and is not legal advice or a substitute for legal counsel. Online readers should not act upon this information without seeking professional counsel. If you would like more information, or would like to speak to a member of Constantine Cannon’s whistleblower lawyer team, please contact us for a Confidential Consultation: https://constantinecannon.com/practice/whistleblower/team/.